Pretreatment chest x-ray severity and its relation to bacterial burden in smear positive pulmonary tuberculosis

Murthy, Saraswathi; Chatterjee, Fiona; Crook, Angela M.; Dawson, Rodney; Mendel, Carl M.; Murphy, Michael E.; Murray, Stephen R.; Nunn, Andrew; Phillips, Patrick P. J.; Singh, Kasha; McHugh, Timothy D.; Gillespie, Stephen H.

doi:10.1186/s12916-018-1053-3

Cited by 44 publications

(36 citation statements)

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“…Furthermore, in multivariate analysis of independent associated indices for lung lesions, higher sputum bacterial counts are associated with cavitation, but not vice versa. Our result is consistent with a recent report that in those cases without cavitation, the radiological severity of disease on chest X-ray prior to treatment in smear-positive pulmonary TB patients has no association with the bacterial burden [ 40 ]. It may therefore explain the seemingly paradox association of BMI [ 41 – 43 ] and anti-TB antibody [ 26 , 44 , 45 ] response with the bacterial counts and cavity in TB patients, in our data and previous reports.…”

Section: Discussionsupporting

confidence: 93%

Sex influences the association between haemostasis and the extent of lung lesions in tuberculosis

et al. 2018

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BackgroundWorldwide tuberculosis (TB) reports show a male bias in morbidity; however, the differences in pathogenesis between men and women with TB, as well as the mechanisms associated with such differences, are poorly investigated. We hypothesized that comparison of the degree of lung injury and clinical indices of well-matched men and women with newly diagnosed TB, and statistical analysis of the correlation between these indices and the extent of lung lesions, can provide insights into the mechanism of gender bias in TB.MethodsWe evaluated the acid-fast bacilli grading of sputum samples and compiled computed tomography (CT) data of the age-matched, newly diagnosed male and female TB patients without history of smoking or comorbidities. Inflammatory biomarker levels and routine haematological and coagulation-associated parameters were compared. Binary logistic regression analysis was used to define the association between the indices and lung lesions, and the influence of sex adjustment.ResultsWomen with TB have a longer delay in seeking healthcare than men after onset of the TB-associated symptoms. Men with TB have significantly more severe lung lesions (cavities and healing-associated features) and higher bacterial counts compared to women with TB. Scoring of the CT images before and after anti-TB treatment showed a faster response to therapy in women than in men. Coagulation- and platelet-associated indices were in models from multivariate regression analysis with groups of males or females with TB or in combination. In univariate regression analysis, lower lymphocyte counts were associated with both cavity and more bacterial counts, independent of sex, age and BMI. The association of international normalized ratios (INR), prothrombin times (PTs), mean platelet volumes (MPVs) and fibrinogen (FIB) level with lung lesions was mostly influenced by sex adjustment.ConclusionsSex influences the association between haemostasis and extent of TB lung lesions, which may be one mechanism involved in sex bias in TB pathogenesis.Electronic supplementary materialThe online version of this article (10.1186/s13293-018-0203-9) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 93%

Sex influences the association between haemostasis and the extent of lung lesions in tuberculosis

et al. 2018

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“…Notably, a significant positive correlation between Rv3737 expression level and bacterial load in pulmonary TB patients raises the possibility that the isolates with increased expression of Rv3737 are prone to escaping clearance by alveolar macrophages, thus leading to greater bacillary multiplication in host. The high bacterial burden always causes more lung damage and higher mortality [24,25]. In line with previous observation, we observed that the higher expression of Rv3737 was more likely to result in more cavities among patients affected by pulmonary TB.…”

Section: Discussionsupporting

confidence: 90%

Rv3737 is required forMycobacterium tuberculosisgrowthin vitroandin vivoand correlates with bacterial load and disease severity in human tuberculosis

Peng

et al. 2021

Preprint

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Rv3737 is the sole homologue of multifunctional transporter ThrE in Mycobacterium tuberculosis (Mtb). In this study, we aimed to investigate whether this transporter participates in vitro and in vivo survival of Mtb. To characterize the role of Rv3737, we constructed and characterized an Mtb H37RvΔRv3737. This strain was evaluated for altered growth rate and macrophage survival using cell model of infection. In addition, the comparative analysis was conducted to determine the association between Rv3737 mRNA expression and disease severity in active pulmonary TB patients. The H37RvΔRv3737 strain exhibited significant slow growth rate compared to H37Rv-WT strain in standard culture medium. Additionally, the survival rate of H37Rv-WT strain in macrophages was 2 folds higher than that of H37RvΔRv3737 at 72 h. A significant higher level of TNF-α and IL-6 mRNA expression was observed in macrophages infected with H37RvΔRv3737 as compared to H37Rv-WT. Of note, Rv3737 expression was significantly increased in clinical Mtb isolates than H37Rv-WT. The relative expression level of Rv3737 was positively correlated with lung cavity number in TB patients. Similarly, the higher Rv3737 mRNA level resulted in lower C(t) value by Xpert MTB/RIF assay, demonstrating that a positive correlation between Rv3737 expression and bacterial load in TB patients. In conclusion, our data is the first to demonstrate that the transporter Rv3737 is required for in vitro growth and survival of bacteria inside macrophages. In addition, the expression level of Rv3737 is associated with bacterial load and disease severity in pulmonary tuberculosis patients.

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“…Whereas, in a study conducted by Murthy et al ., reported that the radiological severity of disease on chest X-ray prior to treatment in smear positive pulmonary TB patients was weakly associated with the bacterial burden. 24 In our study, bilateral lesions were significantly more predominant among PTB patients with diabetes mellitus (69.7%) (Table 4). Also, majority of PTB patients with DM (38.5%) had high bacillary load of 3+.…”

Section: Discussionsupporting

confidence: 55%

Pattern of chest radiographic abnormalities and co-morbidities in newly detected sputum positive pulmonary tuberculosis cases

Ch¹,

Kumbar²,

D.S³

2021

IJIRM

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Background: Tuberculosis (TB) is an airborne communicable disease which one of the leading causes of morbidity and deaths worldwide (ranking above AIDS).1 Probability of detecting AFB on sputum is greatly associated by the radiological findings.8 Because of the apparent widespread difficulty in recognizing the radiographic manifestations of pulmonary tuberculosis, it will be beneficial to review the spectrum of chest x-ray abnormalities in sputum positive tuberculosis patients. Aim: To study clinical features, radiological features and comorbidities among newly detected sputum positive pulmonary tuberculosis patients. Settings and design: The hospital based cross-sectional study was conducted from the year 2016-2018 at a tertiary care teaching hospital in Mangalore. Methodology : Newly diagnosed smear positive pulmonary tuberculosis aged between 18-70 years attending OPD/IPD of Department of Respiratory Medicine, who fulfilled study eligibility criteria were included. Comprehensive clinical assessment was conducted and information regarding socio-demographic profile, comorbidities were noted. Chest x-ray PA view was performed for all patients. Statistical A nalysis: Data was analyzed in SPSS V:20. Data is presented in frequency, percentages. Chisquare, was applied to test significance of association. Results: A total of 563 (309 elderly and 254 adult) patients participated in study. Male predominance was noted (64.7%). Cough (94.1%) and expectoration (83.8%) were the most common symptoms. High bacillary load (3+) and bilateral lungs involvement were predominant among elderly patients (75.6%). Cavitary lesions were predominant among adults. Infiltration (39.6%), cavitary lesions (37.7%) and consolidation (37.5%) were most common lesions seen in chest x-ray. Cavitary lesions were found in higher percentage among patients with higher bacterial load of 2+and 3+ (36.8% and 33.0% respectively). Bilateral lesions were associated with TB patients with diabetes mellitus (69.7%). Conclusions: Infiltration and cavitary lesions among newly diagnosed sputum positive pulmonary tuberculosis patients. Lower zone involvement among female group and Bilateral involvement and atypical lesions among PTB patients with diabetes mellitus were noted. Higher rates of co-morbid conditions like diabetes mellitus, cardiovascular disorders and COPD among elderly TB patients, higher bacillary load and atypical findings among diabetics warrant need for active screening.

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Pretreatment chest x-ray severity and its relation to bacterial burden in smear positive pulmonary tuberculosis

Cited by 44 publications

References 36 publications

Sex influences the association between haemostasis and the extent of lung lesions in tuberculosis

Sex influences the association between haemostasis and the extent of lung lesions in tuberculosis

Rv3737 is required forMycobacterium tuberculosisgrowthin vitroandin vivoand correlates with bacterial load and disease severity in human tuberculosis

Pattern of chest radiographic abnormalities and co-morbidities in newly detected sputum positive pulmonary tuberculosis cases

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